Jun 13, 2017
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Hi Guys,
Can anyone tell me how is lifestyle of PICU or Pediatric Cardiac ICU attending? How many calls per week or per year? Do they have any extra working hours outside of shift? How is the job market and salary?
Thank you!
 

BigRedBeta

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Highly dependent on location and your interests as far as research go.

Attendings at most large academic PICU's are going to have 16-18 weeks of service if they are clinician educators. Those doing bench research are more likely to in the 6-8 week range of clinical service time - but with the expectation of doing research that will grow a lab and earn extramural funding.

Non-service time is not your own, and you'll need to be academically productive, involved in department and hospital committees and teaching students and trainees. Not all academic departments are the same, and the expectations for academic productivity will be very different. Some places, you better be publishing 2-3 (or more) papers a year. In other locations...one publication every 2-3 years will be sufficient.

At the moment, everyone wants people with cardiac experience - which for new fellows means either dual boarded or at least a 4th year Cardiac ICU program. Even big programs seem to be frequently understaffed, and CICU attendings seem to work harder than those of us only in the PICU. Despite that, my perception is that the push to publish is equal or even greater for those in the CICU.

Private practice PICU's will be more service time, but without the responsibility to publish. Usually are smaller, but service weeks may be 7 days on, 24 hours/day. Usually the salary is better. Private practice is harder to find locations that are of sufficient volume and acuity for newly graduated fellows as there still is a significant learning curve in the first 2-4 years after fellowship before you're really a true bada** intensivist.

Call volume also very different. In most situations it's reasonable to expect between 35 and 42 nights of coverage per year - maybe a little less. Most places are going to 24 hour in-house attending coverage. Coverage models vary between night float and more traditional rotating calls. I work 5 weeks of nights a year, and I find it more satisfying for my home life than doing 3-4 nights a month. You have to remember that in most academic places you'll probably work through the following evening after a call night, so you'll go home at 5pm rather than 11am like the residents or fellows.

ICU attendings frequently take part in the sedation service for procedural and imaging sedation. May or may not be part of your required duties, so it may be moonlighting or not.
 
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Jun 13, 2017
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Thank you for your inputs, I appreciate it. Do you know about any centers offering hospitalist positions after residency, so that one can build resume in PICU/PCICU before applying for fellowship? how common or rare are such positions and how can I find about such positions availability?
 

bjackrian

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Plenty of pediatric hospitalist jobs. However they don't help you in getting a fellowship spot and it is financially detrimental to take a pay cut as a fellow once you've begun higher earnings as an attending.
I generally agree with this, but we have had several quite strong applicants who used a year or two of hospitalist work in an academic setting to demonstrate success academically (e.g., research papers, significant QI work, graduate degree, etc.). If the time is use that way or if you're not sure if hospitalist vs. intensivist is right for you, I think it can still be beneficial.

It does seem rare to find a hospitalist job that covers a high-acuity PICU (so your ability to gain experience in PICU/PCICU is limited), though there are a few out there. The ones I've seen have only taken people who did residency at that program so they're getting a known quantity, but there may be others I'm unaware of.
 
Jan 24, 2003
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There are PICU hospitalist jobs out there at large centers and you don't have to be from that residency program. If folks like you, there's no question that it gives you an upper hand for fellowship at that specific program, and definitely gives you a breadth of experience for applying at other fellowships.
 
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